You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


Advertisement

ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | RSS | Access Rights | Sign In


  Vol. 49 No. 10, October 1992 TABLE OF CONTENTS
  Online Only
 •  Online First Table of
Contents
  ORIGINAL ARTICLES
 •Online Features
 This Article
 •References
 •Full text PDF
 • Reply to article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (370)
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Delicious Add to Digg Add to Facebook Add to Reddit Add to Technorati Add to Twitter What's this?

The Course of Depression in Adult Outpatients

Results From the Medical Outcomes Study

Kenneth B. Wells, MD, MPH; M. Audrey Burnam, PhD; Williams Rogers, PhD; Ron Hays, PhD; Patti Camp, MS

Arch Gen Psychiatry. 1992;49(10):788-794.


Abstract



• Objective.—
To compare the course of depression during a 2-year period in adult outpatients (n=626) with current major depression, dysthymia, and either both current disorders ("double depression") or depressive symptoms with no current depressive disorder.

Methods.—
Depressed patients visiting 523 clinicians (mental health specialists and general medical providers) were identified using a two-stage screening procedure including the Diagnostic Interview Schedule. The course of depression was assessed in 2 follow-up years with a structured telephone interview based on the format of the Diagnostic Interview Schedule.

Results.—
Baseline severity of depressive symptoms was greatest in patients with double depression, but initial functional status was poor in those with dysthymia with or without concurrent major depression. Patients with dysthymia had the worst outcomes, those with current major depression alone had intermediate outcomes, and those with subthreshold depressive symptoms had the best outcomes. Even the latter group, however, had a high incidence (25%) of major depressive episode over 2 years. Initial depression severity and level of functional status accounted for more explained variance in outcomes than did type of depressive disorder.

Conclusions.—
The findings emphasize the poor prognosis associated with dysthymia even in the absence of major depression; the prognostic significance of subthreshold depressive symptoms; and the clinical significance of assessing level of severity of symptoms as well as functional status and well-being,` regardless of type of depressive disorder.



Author Affiliations



From The RAND Corporation, Santa Monica, Calif (Drs Wells, Burnam, Rogers, and Hays and Ms Camp), and the Department of Psychiatry and Biobehavioral Sciences, UCLA-Neuropsychiatric Institute and Hospital, Los Angeles (Dr Wells).


Footnotes



Accepted for publication June 26, 1992.

Reprint requests to RAND Corporation, 1700 Main St, PO Box 2138, Santa Monica, CA 90407-2138 (Dr Wells).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Delicious Delicious   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lessons learned from placebo groups in antidepressant trials
Mora et al.
Phil Trans R Soc B 2011;366:1879-1888.
ABSTRACT | FULL TEXT  

A Marginal Structural Model to Estimate the Causal Effect of Antidepressant Medication Treatment on Viral Suppression Among Homeless and Marginally Housed Persons With HIV
Tsai et al.
Arch Gen Psychiatry 2010;67:1282-1290.
ABSTRACT | FULL TEXT  

To Screen or Not to Screen?: Depression in Patients With Cardiovascular Disease
Whooley
J Am Coll Cardiol 2009;54:891-893.
ABSTRACT | FULL TEXT  

The cognitive behavioural analysis system of psychotherapy: a new psychotherapy for chronic depression
Swan and Hull
Adv. Psychiatr. Treat. 2007;13:458-469.
ABSTRACT | FULL TEXT  

The Costs and Benefits of Enhanced Depression Care to Employers
Wang et al.
Arch Gen Psychiatry 2006;63:1345-1353.
ABSTRACT | FULL TEXT  

Three decades of antidepressant, anxiolytic and hypnotic use in a national population birth cohort
Colman et al.
Br. J. Psychiatry 2006;189:156-160.
ABSTRACT | FULL TEXT  

Cost-effectiveness of preventing depression in primary care patients: Randomised trial
SMIT et al.
Br. J. Psychiatry 2006;188:330-336.
ABSTRACT | FULL TEXT  

Minimal-contact psychotherapy for sub-threshold depression in primary care: Randomised trial
Willemse et al.
Br. J. Psychiatry 2004;185:416-421.
ABSTRACT | FULL TEXT  

Increased Incidence of Diagnosed Depressive Illness in Hypogonadal Older Men
Shores et al.
Arch Gen Psychiatry 2004;61:162-167.
ABSTRACT | FULL TEXT  

Coronary artery disease and depression
Zellweger et al.
Eur Heart J 2004;25:3-9.
ABSTRACT | FULL TEXT  

Diagnostic Evaluation of Elderly Patients with Mild Memory Problems
Karlawish and Clark
ANN INTERN MED 2003;138:411-419.
ABSTRACT | FULL TEXT  

ClinfoTracker: A Generalizable Prompting Tool for Primary Care
Nease and Green
J Am Board Fam Med 2003;16:115-123.
ABSTRACT | FULL TEXT  

Managing depression as a chronic disease: a randomised trial of ongoing treatment in primary care
Rost et al.
BMJ 2002;325:934-934.
ABSTRACT | FULL TEXT  

Use, Quality, and Outcomes of Care for Mental Health: The Rural Perspective
Rost et al.
Med Care Res Rev 2002;59:231-265.
ABSTRACT  

Psychoanalytic Patients in the U.S., Canada, and Australia: II. A DSM-III-R Validation Study
Doidge et al.
J Am Psychoanal Assoc 2002;50:615-627.
ABSTRACT  

Longitudinal Study of Psychiatric Symptoms, Disability, Mortality, and Emigration Among Bosnian Refugees
Mollica et al.
JAMA 2001;286:546-554.
ABSTRACT | FULL TEXT  

The Cost-Utility of Screening for Depression in Primary Care
Valenstein et al.
ANN INTERN MED 2001;134:345-360.
ABSTRACT | FULL TEXT  

Time to recovery of an inception cohort with hitherto untreated unipolar major depressive episodes
FURUKAWA et al.
Br. J. Psychiatry 2000;177:331-335.
ABSTRACT | FULL TEXT  

The Influence of Anxiety and Depression on Outcomes of Patients With Coronary Artery Disease
Januzzi et al.
Arch Intern Med 2000;160:1913-1921.
FULL TEXT  

Functional Impairment and Co-occurring Psychiatric Disorders in Medically Hospitalized Men
Booth et al.
Arch Intern Med 1998;158:1551-1559.
ABSTRACT | FULL TEXT  

Late-onset minor and major depression: early evidence for common neuroanatomical substrates detected by using MRI
Kumar et al.
Proc. Natl. Acad. Sci. USA 1998;95:7654-7658.
ABSTRACT | FULL TEXT  

Clinical Correlates of Insomnia in Patients With Chronic Illness
Katz and McHorney
Arch Intern Med 1998;158:1099-1107.
ABSTRACT | FULL TEXT  

Fortnightly review: A regular review of the long term follow up of depression
Angst
BMJ 1997;315:1143-1146.
FULL TEXT  

Depressive Symptoms and the Cost of Health Services in HMO Patients Aged 65 Years and Older: A 4-Year Prospective Study
Unutzer et al.
JAMA 1997;277:1618-1623.
ABSTRACT  

Measuring Health Outcomes for Depression
Sherbourne et al.
Eval Health Prof 1997;20:47-64.
ABSTRACT  

Subthreshold Psychiatric Symptoms in a Primary Care Group Practice
Olfson et al.
Arch Gen Psychiatry 1996;53:880-886.
ABSTRACT  

Treating Major Depression in Primary Care Practice: Eight-Month Clinical Outcomes
Schulberg et al.
Arch Gen Psychiatry 1996;53:913-919.
ABSTRACT  

The Depressions of Alzheimer's Disease: Sorting, Pharmacotherapy, and Clinical Advice
Knesper
J Geriatr Psychiatry Neurol 1995;8:S40-S51.
ABSTRACT  

Health Care Costs of Primary Care Patients With Recognized Depression
Simon et al.
Arch Gen Psychiatry 1995;52:850-856.
ABSTRACT  

Depression in women: implications for health care research
Weissman and Olfson
Science 1995;269:799-801.
ABSTRACT  

Family Study of Early-Onset Dysthymia: Mood and Personality Disorders in Relatives of Outpatients With Dysthymia and Episodic Major Depression and Normal Controls
Klein et al.
Arch Gen Psychiatry 1995;52:487-496.
ABSTRACT  

How Can Care for Depression Become More Cost-effective?
Sturm and Wells
JAMA 1995;273:51-58.
ABSTRACT  

Functioning and Well-being Outcomes of Patients With Depression Compared With Chronic General Medical Illnesses
Hays et al.
Arch Gen Psychiatry 1995;52:11-19.
ABSTRACT  

Untreated Anxiety Among Adult Primary Care Patients in a Health Maintenance Organization
Fifer et al.
Arch Gen Psychiatry 1994;51:740-750.
ABSTRACT  

Psychiatry
Freedman and Stahl
JAMA 1993;270:252-254.
ABSTRACT  

Outcomes for Adult Outpatients With Depression Under Prepaid or Fee-for-Service Financing
Rogers et al.
Arch Gen Psychiatry 1993;50:517-525.
ABSTRACT  

The Course, Morbidity, and Costs of Depression
Klerman and Weissman
Arch Gen Psychiatry 1992;49:831-834.
ABSTRACT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | PHYSICIAN JOBS | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1992 American Medical Association. All Rights Reserved.